Abstract

Background To evaluate the incidence of failure and related factors in patients with regrograde wire technique for the treatment of chronic coronary artery occlusion.

Methods The data of 170 CTO patients undergoing retrograde PCI for a CTO from August 2004 to October 2013.170 cases with chronic coronary artery occlusion underwent transcutaneous coronary artery intervention (PCI) therapy by retrograde wire technique were enrolled in this study (male: 97, mean age: 60.6 ± 11.3 years). Failure is defined as wire is unable to pass through the occlusion of the target – artery or retrograde wire is unable to find the collateral circulation of miraclechannel. And the procedure is failed in stent implantation. We assessed the plasticity and determinants of retrograde wire technique of PCI

Results The data of 170 CTO patients undergoing retrograde PCI for a CTO from August 2004 to October 2013 were analysed. The average occlusion time lasts more than 3.3 years, including 70 LAD CTO and 88 RCA CTO. Retrograde wire technique was failued to performe in 26 patients with chronic coronary artery occlusion. The average of 26 patients were treated by 4.3 guidewires, 1.2 microcatheters and intravascular contrast media 210 ml. there were no significantly changes about left atrial (LA)diameter and and left ventricular (LV) ejection fraction (p > 0.05) between success group and failue group. There were 26 patients (26/170, 15.2%) with at least one reason, including 17 cases with the wire is unable to pass through the collosion; 2 cases with small right coronary artery; 7 cases with bad collateral miraclechannel. In logistic regression analysis, the occlusion time between 3–12 months and whether the target artery had received antigrade wire technique before were the independent predictors of failure rate.

Conclusions According to the data, the success rate of the occlusion time between 3–12 months is the lower than 1–3 years. There is no difference of the success rate between occlusion segment ≥15 mm and <15 mm, which is different from the previous view. Retrograde wire technique significantly increases the success rate of procedure in patients who failed in antegrade wire technique.

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